Intermenstrual Bleeding

Refer to Menstrual Disorders Clinic with pelvic USS attached


Vaginal bleeding (other than post coital) at any time in the cycle other than during normal menstruation


  • Persistent  bleeding in >45 years or risk factors  eg obesity, PCOS unopposed estrogen, tamoxifen) –Refer urgently and request USS
  • Suspicious cervix on examination- Refer  2ww
  • Otherwise routine referral


Information to include in referral letter 

  • Problem and length of symptoms
  • Current contraception
  • Smear history (including last smear & result) the patient will still be seen without this but if you can retrieve it automatically it speeds up the consultation 
  • Speculum findings (eg normal / ectropion / cervicitis / cervical polyp) 

Investigations prior to referral

  • Chlamydia screening
  • High Vaginal Swab
  • Pelvic USS
  • NB DON’T perform a cervical smear if outside the screening programme


Date Reviewed                        27/6/2019

Next Review Date        27/6/2020

Dr Anna Harrold


Version 2.0